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. 2011 Oct;18(10):2925-36.
doi: 10.1245/s10434-011-1706-3. Epub 2011 Apr 9.

Racial differences in survival after surgical treatment for melanoma

Karen Kadela Collins  1 , Ryan C Fields, Dadrie Baptiste, Ying Liu, Jeffrey Moley, Donna B Jeffe
Affiliations

Racial differences in survival after surgical treatment for melanoma

Karen Kadela Collins et al. Ann Surg Oncol. 2011 Oct.

Abstract

Background: Surgical-treatment outcomes for melanoma in African Americans are poorly characterized as a result of low incidence of melanoma among African Americans. We examined differences by race in overall and melanoma-specific survival, stratified by receipt of surgical treatment and by specific types of surgical treatment.

Methods: Data from the 1973-2004 public-use Surveillance, Epidemiology and End Results Program (SEER) were analyzed by Cox proportional hazard models to compare the effects of surgical treatments on overall and melanoma-specific survival in blacks, whites, and other race, controlling for confounding demographic and tumor-related variables.

Results: Of 151,154 patients with first primary melanoma (148,883 whites, 789 blacks and 1,532 other race), 142,653 (94.4%) received surgical treatment. Among patients who received surgical treatment, 10-year melanoma-specific survival was lower in blacks (73%) than in whites (88%) and other race (85%); black patients were at significantly higher risk of overall and melanoma-specific mortality when compared with white (hazard ratio [HR] = 1.64, 95% confidence interval [CI] 1.44-1.86, P < 0.0001 and HR = 1.50, 95% CI 1.25-1.79, P < 0.0001, respectively) and with other race (HR = 1.55, 95% CI 1.31-1.85, P < 0.0001 and HR = 1.49, 95% CI 1.16-1.91, P = 0.0017, respectively). Blacks who underwent biopsy, wide excision and surgery not otherwise specified were at higher risk of overall mortality compared with whites with the same treatment.

Conclusion: Overall and melanoma-specific survival was lower in blacks undergoing surgical treatment for melanoma compared to both whites and other race. Reasons for these disparities remain poorly understood.

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Figures

Figure 1
Figure 1
Kaplan Meier analyses indicating differences in overall and melanoma-specific survival between patients who had surgery and patients who did not have surgery stratified by race. P values are log-rank tests. Overall survival: Surgery, P < 0.0001; No surgery, P = 0.1405. Melanoma-specific survival: Surgery, P < 0.0001; No surgery, P = 0.2595.
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